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LATORNELL CONSERVATION SYMPOSIUM A) NOMINEE INFORMATION NAME OF NOMINEE:  FORMTEXT      TITLE:  FORMTEXT      ADDRESS:  FORMTEXT      PHONE:  FORMTEXT      E-MAIL:  FORMTEXT      NAME OF NOMINATING GROUP:  FORMTEXT      ADDRESS:  FORMTEXT      PHONE:  FORMTEXT      E-MAIL:  FORMTEXT      CONTACT:  FORMTEXT      B) CONTRIBUTIONS MADE IN THE FOLLOWING AREAS (check all applicable categories):  FORMCHECKBOX Conservation legislation/policy development/reform FORMCHECKBOX Conservation innovation FORMCHECKBOX Environmental education/communication FORMCHECKBOX Habitat Enhancement FORMCHECKBOX Natural resource management/planning FORMCHECKBOX Conservation research/field work/studies FORMCHECKBOX Advocacy/Leadership FORMCHECKBOX Community organization FORMCHECKBOX other, please specify:  FORMTEXT      C) BIOGRAPHY (Maximum of 2 pages attached to this nomination form): Remember to answer the following three questions: What are the nominee s accomplishments (both professionally and/or in a volunteer capacity) to the (local and/or provincial and/or0z|ķkZ>k%1jhLCJOJQJU\^JmHnHsH u6jho?hC CJOJQJU\^JmH sH !ho?CJOJQJ\^JmH sH *jho?CJOJQJU\^JmH sH $h5CJOJQJ\^JmH sH *hh5CJOJQJ\^JmH sH hhg>*B*phffhh}Z>*B*phffhh>*B*phff-h}Z5B*CJOJQJ\^JmH ph3fsH -h}Z5B*CJ OJQJ\^JmH ph3fsH |* , f h ACkd$$Ifl*+ t644 laytC Vkd$$Ifl0* t644 layt 0*d$Ifgddhgdo? 0*Bdn8v8      & ( < > @ T V X b d h t v x z_׮B_9jhhJX5CJOJQJU\^JmH sH 4jhL5CJOJQJU\^JmHnHsH u9jthhJX5CJOJQJU\^JmH sH -jhJX5CJOJQJU\^JmH sH $hJX5CJOJQJ\^JmH sH *hh5CJOJQJ\^JmH sH $h5CJOJQJ\^JmH sH *jho?CJOJQJU\^JmH sH   " $ & 0 2 F ˰˝ttW˰˝tt:˰˝9jhhJX5CJOJQJU\^JmH sH 9jhhJX5CJOJQJU\^JmH sH $hJX5CJOJQJ\^JmH sH *hh5CJOJQJ\^JmH sH $h5CJOJQJ\^JmH sH 4jhL5CJOJQJU\^JmHnHsH u-jhJX5CJOJQJU\^JmH sH 9jvhhJX5CJOJQJU\^JmH sH h 4 6 p @Ckdj$$Ifl*+ t644 laytC  0*d$IfgdC Vkd^$$Ifl0* t644 layt 0*d$IfgdF H J ^ ` b l n r ~ ֞֋uX֞֋u;9jVhhJX5CJOJQJU\^JmH sH 9jhhJX5CJOJQJU\^JmH sH *hh5CJOJQJ\^JmH sH $h5CJOJQJ\^JmH sH 4jhL5CJOJQJU\^JmHnHsH u9jhhJX5CJOJQJU\^JmH sH -jhJX5CJOJQJU\^JmH sH $hJX5CJOJQJ\^JmH sH p r  RVkd$$Ifl0* t644 layt 0*d$IfgdC Ckd`$$Ifl*+ t644 laytC       躧dNA7/jho?Uh9B*phffhh9B*phff*hh5CJOJQJ\^JmH sH 9jbhhJX5CJOJQJU\^JmH sH $hJX5CJOJQJ\^JmH sH $hJX5CJOJQJ\^JmH sH $h5CJOJQJ\^JmH sH $h5CJOJQJ\^JmH sH 4jhL5CJOJQJU\^JmHnHsH u-jhJX5CJOJQJU\^JmH sH   $ 6 N $d$Ifa$gdo? d$Ifgdo? $$Ifa$gdo? 0*dhgdo?Ckd$$Ifl*+ t644 laytC  # $ % 3 4 5 6 M O P ^ _ ` a  ! " 0 1 2 3 F G H V ♔j\ ho?U ho?5 ho?ho?j$ ho?Uj ho?Ujx ho?Uj ho?Uhho?mH sH jho?U hho?jho?UjXhC Uho?2N O a vj[j$d$Ifa$gdo? d$Ifgdo? $$Ifa$gdo?|kd@ $$Ifl\}0*  t644 layto? vj[j$d$Ifa$gdo? d$Ifgdo? $$Ifa$gdo?|kd $$Ifl\}0*  t644 layto? ! 3 G Y p vj[j$d$Ifa$gdo? d$Ifgdo? $$Ifa$gdo?|kd $$Ifl\}0*  t644 layto?V W X Y p q r   2z4|4444556谦uh^T^hLCJmH sH h. CJmH sH h. h}Z9B*phffh. h9B*phffh. h. 9B*phffU(h. h. CJOJQJ^JaJmH sH h. 9B*phffho?h. 9B*phffjhLUmHnHuj|hC Ujho?U hho?ho?jho?Uj ho?U p q vj d$Ifgdo? $$Ifa$gdo?|kdD$$Ifl\}0*  t644 layto?H23z445556{mmmm p0*dgd.  0*dhgd. & Fgd. gd.  0*dhgdo?Vkd$$Ifl0}0*( t644 laytC national) conservation community? How long has the nominee been involved in (local and/or provincial and/or national) conservation issues and what actions he or she has taken to protect and/or promote land and water conservation? How has the nominee s work helped to inspire young people in the conservation field? D) SUPPORTING DOCUMENTATION: Remember to submit a maximum of 4 items of supporting documentation (ie. letters of support, news clippings) Please submit this form in full, including all support material, to: A.D. 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